Hernia into the foramen of Winslow

Abstract

Pattison Prize in Clinical Surgery 1909

1. If no threatening signs of pressure are present, one should always begin with medical treatment, i.e., complete rest, restricted diet and large doses of potassium iodide. •

2.If the above medical treatment does not benefit the condition, and pressure signs, etc. become more marked,then simultaneous ligature of the subclavian and right common carotid artery should be attempted. •

3. This operation must be carried out at as early a date as possible. If no improvement results from medical treatment, delay is dangerous, as more arteries may become occluded and the older the aneurism the greater is the chance of a rupture either externally or internally. •

4. Operation is contraindicated if there is obliteration of the left carotid or dilatation of the aorta. •

5. If the operation fails, or the aneurism be too large for ligature of these arteries, then needling or the subcutaneous injection of gelatin should be attempted. •

6. Ligature of the innominate artery should never be attempted except as a last resource. •

7. If all these methods fail, then there only remains medical treatment, and protection of the sac from injury.